Orbital Myeloid Sarcoma (chloroma): Report of 2 Cases and Literature Review

Overview

Journal Am J Ophthalmol Case Rep

Specialty Ophthalmology

Date 2020 Aug 11

PMID 32775766

Citations 9

Authors

Mohammad A AlSemari

Marianna Perrotta

Camilla Russo

Hind M Alkatan

A Maktabi

S Elkhamary

Rosa Maria Di Crescenzo

Massimo Mascolo

Andrea Elefante

Luca Rombetto

Raffaella Capasso

Diego Strianese

Affiliations

Soon will be listed here.

Abstract

Purpose: Myeloid sarcoma (MS) of the orbit is an uncommon condition in occurring in children, generally coupled to myeloproliferative neoplasms.

Observations: We describe two rare cases of orbital MS in young boys with aggressive local symptoms but without evidence of acute myeloid leukemia (AML), both patients underwent orbitotomy for gross-tumor resection and biopsy. At follow up, there was no evidence of recurrence nor evolution of the myeloproliferative neoplasms clinically and by radiological and laboratory work-up. We also provide a detailed description of the magnetic resonance imaging presentation, with an extensive pathological analysis correlation.

Conclusions And Importance: A comprehensive revision of the literature on isolated orbital MS was carried out with particular emphasis on clues for differential diagnosis and treatment options, stressing the need to consider MS even in the absence of sign and symptoms of an underlying myeloproliferative disorders.

Citing Articles

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PMID: 39958139 PMC: 11830221. DOI: 10.7759/cureus.77580.

Isolated orbital granulocytic sarcoma.

Li Z, Chen W, Xu C Eye (Lond). 2024; 39(Suppl 1):4-5.

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Case report: Orbital myeloid sarcoma: a report of two rare cases and review of the literature.

Li Y, Wang Y, He W Pathol Oncol Res. 2024; 30:1611818.

PMID: 39525664 PMC: 11543479. DOI: 10.3389/pore.2024.1611818.

Pediatric orbital lesions: neoplastic extraocular soft-tissue lesions.

Gerrie S, Branson H, Lyons C, Marie E, Rajani H, Frayn C Pediatr Radiol. 2024; 54(6):922-935.

PMID: 38480589 DOI: 10.1007/s00247-024-05891-y.

Regression of a Myeloid Sarcoma of the Nasal Cavity With Extension to the Cheek After Radiotherapy.

Morchid S, Sellal N, El Boutahiri I, Regragui S, El Hfid M Cureus. 2023; 15(7):e41273.

PMID: 37533617 PMC: 10392285. DOI: 10.7759/cureus.41273.

References

Guermazi A, Feger C, Rousselot P, Merad M, Benchaib N, Bourrier P . Granulocytic sarcoma (chloroma): imaging findings in adults and children. AJR Am J Roentgenol. 2002; 178(2):319-25. DOI: 10.2214/ajr.178.2.1780319. View

Chung E, Smirniotopoulos J, Specht C, Schroeder J, Cube R . From the archives of the AFIP: Pediatric orbit tumors and tumorlike lesions: nonosseous lesions of the extraocular orbit. Radiographics. 2007; 27(6):1777-99. DOI: 10.1148/rg.276075138. View

Purohit B, Vargas M, Ailianou A, Merlini L, Poletti P, Platon A . Orbital tumours and tumour-like lesions: exploring the armamentarium of multiparametric imaging. Insights Imaging. 2015; 7(1):43-68. PMC: 4729705. DOI: 10.1007/s13244-015-0443-8. View

Samborska M, Derwich K, Skalska-Sadowska J, Kurzawa P, Wachowiak J . Myeloid sarcoma in children - diagnostic and therapeutic difficulties. Contemp Oncol (Pozn). 2017; 20(6):444-448. PMC: 5320455. DOI: 10.5114/wo.2016.65602. View

Aggarwal E, Mulay K, Honavar S . Orbital extra-medullary granulocytic sarcoma: clinicopathologic correlation with immunohistochemical features. Surv Ophthalmol. 2014; 59(2):232-5. DOI: 10.1016/j.survophthal.2013.06.004. View

Yamauchi K, Yasuda M . Comparison in treatments of nonleukemic granulocytic sarcoma: report of two cases and a review of 72 cases in the literature. Cancer. 2002; 94(6):1739-46. DOI: 10.1002/cncr.10399. View

Alexiev B, Wang W, Ning Y, Chumsri S, Gojo I, Rodgers W . Myeloid sarcomas: a histologic, immunohistochemical, and cytogenetic study. Diagn Pathol. 2007; 2:42. PMC: 2186303. DOI: 10.1186/1746-1596-2-42. View

Hakyemez B, Yildirim N, Taskapilioglu O, Erdogan C, Aker S, Yilmazlar S . Intracranial myeloid sarcoma: conventional and advanced MRI findings. Br J Radiol. 2007; 80(954):e109-12. DOI: 10.1259/bjr/16630393. View

Strianese D, Elefante A, Matarazzo F, Panico A, Ferrara M, Tranfa F . Orbital lymphoma mimicking lacrimal gland pleomorphic adenoma. Case Rep Ophthalmol. 2013; 4(3):109-13. PMC: 3806700. DOI: 10.1159/000354963. View

10.

Bakst R, Wolden S, Yahalom J . Radiation therapy for chloroma (granulocytic sarcoma). Int J Radiat Oncol Biol Phys. 2011; 82(5):1816-22. PMC: 5045241. DOI: 10.1016/j.ijrobp.2011.02.057. View

11.

Kiratli H, Sekeroglu M, Guler Tezel G . Orbital heterotopic glial tissue presenting as exotropia. Orbit. 2008; 27(3):165-8. DOI: 10.1080/01676830701523889. View

12.

Chirapapaisan N, Chuenkongkaew W, Pornpanich K, Vangveeravong S . Orbital pseudotumor: clinical features and outcomes. Asian Pac J Allergy Immunol. 2008; 25(4):215-8. View

13.

Bitan M, He W, Zhang M, Abdel-Azim H, Ayas M, Bielorai B . Transplantation for children with acute myeloid leukemia: a comparison of outcomes with reduced intensity and myeloablative regimens. Blood. 2014; 123(10):1615-20. PMC: 3945869. DOI: 10.1182/blood-2013-10-535716. View

14.

Thakur B, Varma K, Misra V, Chauhan S . Granulocytic sarcoma presenting as an orbital mass: report of two cases. J Clin Diagn Res. 2013; 7(8):1704-6. PMC: 3782940. DOI: 10.7860/JCDR/2013/5582.3260. View

15.

Janeckova V, Semerad L, Jeziskova I, Dvorakova D, culen M, Sustkova Z . [Molecular Genetic Testing for Acute Myeloid Leukemia]. Klin Onkol. 2016; 29(6):411-418. DOI: 10.14735/amko2016411. View

16.

Maka E, Lukats O, Toth J, Fekete S . Orbital tumour as initial manifestation of acute myeloid leukemia: granulocytic sarcoma: case report. Pathol Oncol Res. 2008; 14(2):209-11. DOI: 10.1007/s12253-008-9028-x. View

17.

Ahmed S, Goel S, Khandwala M, Agrawal A, Chang B, Simmons I . Neuroblastoma with orbital metastasis: ophthalmic presentation and role of ophthalmologists. Eye (Lond). 2005; 20(4):466-70. DOI: 10.1038/sj.eye.6701912. View

18.

Campidelli C, Agostinelli C, Stitson R, Pileri S . Myeloid sarcoma: extramedullary manifestation of myeloid disorders. Am J Clin Pathol. 2009; 132(3):426-37. DOI: 10.1309/AJCP1ZA7HYZKAZHS. View

19.

Tortora F, Prudente M, Cirillo M, Elefante A, Belfiore M, Romano F . Diagnostic accuracy of short-time inversion recovery sequence in Graves' Ophthalmopathy before and after prednisone treatment. Neuroradiology. 2014; 56(5):353-61. DOI: 10.1007/s00234-014-1332-4. View

20.

Noh B, Park S, Chun J, Kim J, Kim H, Lim M . Granulocytic Sarcoma in the Head and Neck: CT and MR Imaging Findings. Clin Exp Otorhinolaryngol. 2009; 2(2):66-71. PMC: 2702726. DOI: 10.3342/ceo.2009.2.2.66. View